Bone fusion device, system and method

ABSTRACT

A bone fusion method, system and device for insertion between bones that are to be fused together in order to replace degenerated discs and/or bones, for example, the vertebrae of a spinal column. The bone fusion device comprises a frame and one or more extendable plates that are able to be angled, rotatable, adjustable, and have top profiles designed to correct and/or match the replaced discs/bones. The bone fusion device is able to be inserted between or replace the vertebrae by using a minimally invasive procedure wherein the dimensions and/or other characteristics of the bone fusion device are selectable based on the type of minimally invasive procedure.

RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.13/571,254, filed on Aug. 9, 2012 and entitled “BONE FUSION DEVICE,SYSTEM AND METHOD,” which claims priority under 35 U.S.C. § 119(e) ofU.S. Provisional Patent Application Ser. No. 61/521,678, filed Aug. 9,2011, and entitled “BONE FUSION DEVICE, SYSTEM AND METHOD,” all of whichare hereby incorporated by reference.

FIELD OF THE INVENTION

This invention relates generally to bone fusion devices. Morespecifically, the present invention relates to devices for fusingvertebrae of the spine or other bones.

BACKGROUND OF THE INVENTION

The spinal column is made up of vertebrae stacked on top of one another.Between the vertebrae are discs which are gel-like cushions that act asshock-absorbers and keep the spine flexible. Injury, disease, orexcessive pressure on the discs can cause degenerative disc disease orother disorders where the disc becomes thinner and allows the vertebraeto move closer together or become misaligned. Similarly, vertebrae areable to weaken due to impact or disease reducing their ability toproperly distribute forces on the spine. As a result, nerves may becomepinched, causing pain that radiates into other parts of the body, orinstability of the vertebrae may ensue.

One method for correcting disc and/or vertebrae-related disorders is toinsert a fusion cage as a replacement for and/or in between thevertebrae to act as a structural replacement for the deteriorated discand/or vertebrae. The fusion cage is typically a hollow metal deviceusually made of titanium. Once inserted, the fusion cage maintains theproper separation between the vertebrae to prevent nerves from beingpinched and provides structural stability to the spine. Also, the insideof the cage is filled with bone graft material which eventually fusespermanently with the adjacent vertebrae into a single unit. However, itis difficult to retain this bone graft material in the cage and in theproper positions to stimulate bone growth.

The use of fusion cages for fusion and stabilization of vertebrae in thespine is known in the prior art. U.S. Pat. No. 4,961,740 to Ray, et al.entitled, “V-Thread Fusion Cage and Method of Fusing a Bone Joint,”discloses a fusion cage with a threaded outer surface, where the crownof the thread is sharp and cuts into the bone. Perforations are providedin valleys between adjacent turns of the thread. The cage can be screwedinto a threaded bore provided in the bone structure at the surgical siteand then packed with bone chips which promote fusion.

U.S. Pat. No. 5,015,247 to Michelson entitled, “Threaded SpinalImplant,” discloses a fusion implant comprising a cylindrical memberhaving a series of threads on the exterior of the cylindrical member forengaging the vertebrae to maintain the implant in place and a pluralityof openings in the cylindrical surface.

U.S. Pat. No. 6,342,074 to Simpson entitled, “Anterior Lumbar UnderbodyFusion Implant and Method For Fusing Adjacent Vertebrae,” discloses aone-piece spinal fusion implant comprising a hollow body having anaccess passage for insertion of bone graft material into theintervertebral space after the implant has been affixed to adjacentvertebrae. The implant provides a pair of screw-receiving passages thatare oppositely inclined relative to a central plane. In one embodiment,the screw-receiving passages enable the head of an orthopaedic screw tobe retained entirely within the access passage.

U.S. Pat. No. 5,885,287 to Bagby entitled, “Self-tapping Interbody BoneImplant,” discloses a bone joining implant with a rigid, implantablebase body having an outer surface with at least one bone bed engagingportion configured for engaging between a pair of bone bodies to bejoined, wherein at least one spline is provided by the bone bed engagingportion, the spline being constructed and arranged to extend outwardlyof the body and having an undercut portion.

U.S. Pat. No. 6,582,467 to Teitelbaum et al. entitled, “ExpandableFusion Cage,” discloses an expandable fusion cage where the surfaces ofthe cage have multiple portions cut out of the metal to form sharpbarbs. As the cage is expanded, the sharp barbs protrude into thesubcortical bone of the vertebrae to secure the cage in place. The cageis filled with bone or bone matrix material.

U.S. Pat. No. 5,800,550 to Sertich entitled, “Interbody Fusion Cage,”discloses a prosthetic device which includes an inert generallyrectangularly shaped support body adapted to be seated on hard endplates of vertebrae. The support body has top and bottom faces. A firstpeg is movably mounted in a first aperture located in the support body,and the first aperture terminates at one of the top and bottom faces ofthe support body. Further, the first peg projects away from the one ofthe top and bottom faces and into an adjacent vertebra to secure thesupport body in place relative to the vertebra.

U.S. Pat. No. 6,436,140 to Liu et al. entitled, “Expandable InterbodyFusion Cage and Method for Insertion,” discloses an expandable hollowinterbody fusion device, wherein the body is divided into a number ofbranches connected to one another at a fixed end and separated at anexpandable end. The expandable cage may be inserted in its substantiallycylindrical form and may be expanded by movement of an expansion memberto establish lordosis of the spine. An expansion member interacts withthe interior surfaces of the device to maintain the cage in the expandedcondition and provide a large internal chamber for receiving bonein-growth material.

These patents all disclose fusion cage devices that can be insertedbetween vertebrae of the spine in an invasive surgical procedure. Suchan invasive surgical procedure requires a long recovery period.

SUMMARY OF THE INVENTION

The present invention is a bone fusion method, system and device forinsertion between bones that are to be fused together in order toreplace degenerated discs and/or bones, for example, the vertebrae of aspinal column. The bone fusion device comprises a frame and one or moreextendable plates that are able to be angled, rotatable, adjustable, andhave top profiles designed to correct and/or match the replaceddiscs/bones. The bone fusion device is able to be inserted between orreplace the vertebrae by using minimally invasive procedure wherein thedimensions and/or other characteristics of the bone fusion device areselectable based on the type of minimally invasive procedure. The bonefusion device of some embodiments is filled and/or surrounded with bonegraft material, wherein the bone graft material is maintained in desiredshapes and locations in relation to the bones with one or more meshbags. In some embodiments, one or more of the bone fusion devices areable to be coupled together and/or with a bone replacement body. As aresult, the bone fusion device, system and method is able to customizedto the needs of the surgeon and patient thereby increasing theeffectiveness and safety of the bone fusion procedures.

A first aspect of the present application is directed to a bone fusiondevice for insertion into a desired location. The bone fusion devicecomprises a body having a first end and an interior cavity, one or moretabs each having a support rib, wherein the tabs are configured toselectively move from a retracted position within the body to anextended position extending out of the body and one or more extendingblocks configured to slide within the body in order to move the tabsbetween the retracted position and the extended position, wherein theextending blocks each have a rib slot and are positioned adjacent to thetabs within the interior cavity such that each support rib slides withinone or more of the rib slots when the tabs move between the retractedposition and the extended position. In some embodiments, the outwardfacing surface of the tabs comprise a plurality of teeth such that theoutward facing surface is serrated. In some embodiments, the bodycomprises an exterior surface having one or more surface channels. Insome embodiments, each of the surface channels comprise a grippingaperture for receiving a fingertip of a finger of a gripping apparatuspositioned within the surface channels. In some embodiments, the devicefurther comprises a positioning element having a positioning apertureand mechanically coupled with the extending blocks such that moving thepositioning element causes the extending blocks to slide within thebody. In some embodiments, the surface channels are positioned along theexterior surface on a plane perpendicular to the aperture of thepositioning element such that the fingers of the gripping apparatus areable to enter the one or more surface channels by moving parallel to theplane. In some embodiments, the body of the bone fusion device has aheight of less than or equal to 5 mm. In some embodiments, the bonefusion device consists of a single tab. In some embodiments, the bodyhas a top view profile selected from the group consisting of oval,kidney shaped, round and banana shaped. In some embodiments, one or moreof the tabs have a top view profile selected from the group consistingof oval, kidney shaped, round and banana shaped. In some embodiments,the tabs have a top view profile with the same shape as the top viewprofile of the body. In some embodiments, the positioning aperture of anangled portion of the positioning element is accessible from exterior tothe body at an angle non-parallel with the direction of motion of theextending blocks. In some embodiments, the outward facing surface of thetabs is non-planar. In some embodiments, the outward facing surface ofthe tabs is convex or concave. In some embodiments, the plane of theoutward facing surface of the tabs is angled with respect to the planeof the bottom of the tabs. In some embodiments, the tabs are modular anddetachably coupled to the body such that a tab is able to be selectivelyremoved and replaced by another tab. In some embodiments, the tabs arerotatable with respect to the body. In some embodiments, the devicefurther comprises one or more bone graft bags coupled to the body forholding bone graft material. In some embodiments, the bone graft bagsare coupled to the exterior of the body. In some embodiments, the bonegraft bags are positioned within the interior cavity. In someembodiments, the bone graft bags comprise a mesh frame having one ormore support bars such that the bone graft bags are not flaccid. In someembodiments, the bone graft bags comprise one or more openings forinserting bone graft material and a bag fastener configured to close theopening. In some embodiments, the bone graft bags have a cylindricalshape.

A second aspect of the present application is directed to a method ofimplanting a bone fusion device into a desired location. The methodcomprises inserting the bone fusion device in the desired location,wherein the bone fusion device comprises a body having an interiorcavity that houses one or more tabs each having an inner surface and asupport rib, and one or more extending blocks each having a rib slot andextending the one or more tabs from a retracted position within theinterior cavity to an extended position at least partially outside theinterior cavity by moving at least one of the plurality of extendingblocks along the inner surface of the tabs such that the rib slots slidealong the support ribs positioned at least partially within the ribsslots. In some embodiments, the method further comprises retracting thetabs of the bone fusion device into the retracted position beforeinserting the bone fusion device into the desired location. In someembodiments, moving the extending blocks comprises manipulating apositioning element of the bone fusion device coupled with the extendingblocks and having a positioning aperture. In some embodiments, themethod further comprises securing a gripping apparatus to the bonefusion device by inserting one or more fingers of the gripping apparatusinto one or more channels on the exterior surface of the body of thebone fusion device. In some embodiments, the method further comprisessecuring the fingers within the channels by inserting one or morefingertips of the fingers into one or more apertures of the channels. Insome embodiments, the channels are positioned along the exterior surfaceon a plane perpendicular to the positioning aperture such that thefingers of the gripping apparatus are able to enter the channels bymoving parallel to the plane. In some embodiments, an outward facingsurface of the tabs comprises a plurality of teeth such that the outwardfacing surface is serrated. In some embodiments, the method furthercomprises selecting a bone fusion device having a body with a top viewprofile that substantially matches the cross-sectional profile of thebones from a plurality of bone fusion devices having bodies withdifferent top view profiles. In some embodiments, the method furthercomprises selecting a bone fusion device having tabs with a top viewprofile that substantially matches the cross-sectional profile of thebones from a plurality of bone fusion devices having tabs with differenttop view profiles. In some embodiments, the method further comprisesselecting a bone fusion device having an angled portion of thepositioning element with a positioning aperture that is accessible fromexterior to the body at an angle that substantially matches the angle ofattack of the type of surgery. In some embodiments, the insertion thebone fusion device is at an angle corresponding to a type of surgeriesare selected from the group consisting of anterior, posterior, lateral,far-lateral, extra-lateral, extreme-lateral and transforminal. In someembodiments, the method further comprises selecting one or more tabshaving a non-planar outward facing surface that substantiallycorresponds to the surface of the bones to be contacted from a pluralityof tabs with different non-planar outward facing surfaces. In someembodiments, the method further comprises selecting one or more tabswith outward facing surfaces having planes with respect to the plane ofthe bottom of the tabs that correspond to the angle of the plane of thesurface of the bones to be contacted from a plurality of tabs withoutward facing surfaces having planes of different angles with respectto the plane of the bottom of the tabs. In some embodiments, the methodfurther comprises replacing one or more of the tabs of the bone fusiondevice with one or more replacement tabs. In some embodiments, themethod further comprises rotating the tabs in the extended positionuntil the tabs are at a desired angle with respect to the body. In someembodiments, the method further comprises inserting bone graft materialinto the bone graft bags through the openings and then closing theopenings with the bag fastener. In some embodiments, the method furthercomprises coupling the bone graft bags to the body.

A third aspect of the present application is directed to a bone fusionsystem for insertion into a desired location. The system comprises oneor more bone fusion devices each comprising a body having an interiorcavity and one or more tabs having one or more device fasteners, whereinthe tabs are configured to selectively extend from a retracted positionwithin the interior cavity to an extended position at least partiallyoutside of the interior cavity and one or more spacers having one ormore spacer fasteners, wherein the spacer fasteners are configured todetachably couple to the device fasteners in order to couple the one ormore bone fusion devices to the one or more spacers. In someembodiments, the one or more spacers are hollow. In some embodiments,the device fasteners are configured to detachably couple to other devicefasteners in order to couple two or more bone fusion devices together.In some embodiments, the spacer fasteners are configured to detachablycouple to other spacer fasteners in order to couple two or more spacerstogether. In some embodiments, the spacer fasteners and the devicefasteners comprise one or more rails and one or more slats, wherein theslats are configured to slid under the one or more rails in order todetachably couple the spacer fasteners and the device fastenerstogether. In some embodiments, the one or more slats and one or morerails comprise one or more snap-fit members and one or more cutouts,wherein the snap-fit members are configured to depress when the slatsare slid under the rails and spring into the one or more cutouts whenaligned with the one or more cutouts in order to prevent the slats fromsliding out from under the rails. In some embodiments, the bodycomprises one or more device fasteners.

A fourth aspect of the present application is directed to a bone fusiondevice for insertion into a desired location. The device comprises abody having an interior cavity and one or more tabs having one or moredevice fasteners, wherein the tabs are configured to selectively extendfrom a retracted position within the interior cavity to an extendedposition at least partially outside of the interior cavity, and furtherwherein the device fasteners are configured to detachably couple to eachother in order to couple the bone fusion device to other bone fusiondevices. In some embodiments, the body comprises one or more devicefasteners configured to detachably couple to other device fasteners inorder to couple the body of the bone fusion device to other bone fusiondevices. In some embodiments, the device fasteners comprise one or morerails and one or more slats, wherein the slats are configured to slidunder the one or more rails in order to detachably couple the devicefasteners together. In some embodiments, the one or more slats and oneor more rails comprise one or more snap-fit members and one or morecutouts, wherein the snap-fit members are configured to depress when theslats are slid under the rails and spring into the one or more cutoutswhen aligned with the one or more cutouts in order to prevent the slatsfrom sliding out from under the rails.

Another aspect of the present application is directed to a method ofimplanting a bone fusion apparatus into a desired location having aheight. The method comprises detachably coupling together two or more ofthe group consisting of bone fusion devices having a body and one ormore extendable tabs and spacers to form a bone fusion assembly,inserting the bone fusion assembly into the desired location andextending one or more of the tabs out from the bodies to extendedpositions such that the height of the bone fusion assembly issubstantially similar to the height of the desired location. In someembodiments, the number of spacers and bone fusion devices coupledtogether is based on the height of the desired location. In someembodiments, the one or more spacers are hollow. In some embodiments,the detachably coupling comprises coupling one of the bone fusiondevices to another of the bone fusion device. In some embodiments, thedetachably coupling comprises coupling one of the spacers to another ofthe spacers. In some embodiments, the detachably coupling comprisescoupling one of the spacers to one or more of the bone fusion devices.In some embodiments, the bone fusion devices and spacers comprise one ormore rails and one or more slats and the detachably coupling comprisessliding the slats under the rails. In some embodiments, the one or moreslats and one or more rails comprise one or more snap-fit members andone or more cutouts and the detachably coupling comprises depressing thesnap-fit members when the slats are slid under the rails and springingthe snap-fit members into the one or more cutouts when the snap-fitmembers are aligned with one or more of the cutouts in order to preventthe slats from sliding out from under the rails.

Another aspect of the present application is directed to a bone fusiondevice for insertion into a desired location. The bone fusion devicecomprises a body having an interior cavity, one or more tabs having anoutward facing surface and configured to selectively move between aretracted position within the interior cavity and an extended positionextending out of the body in order to brace the bone fusion device inthe desired location and a tab positioning assembly coupled with the oneor more tabs within the interior cavity, the tab positioning assemblyhaving an extension positioning element configured to move the tabsbetween the retracted position and the extended position and an anglepositioning element configured to change the angle of the outward facingsurface with respect to the body. In some embodiments, the tabpositioning assembly is configured to enable the position of the tabsbetween the retracted position and the extended position and the angleof the outward facing surface with respect to the body to be adjustedindependently. In some embodiments, the tab positioning assembly isconfigured to enable the position of the tabs between the retractedposition and the extended position and the angle of the outward facingsurface with respect to the body to be adjusted simultaneously.

Another aspect of the present application is directed to a method ofimplanting a bone fusion apparatus into a desired location. The methodcomprises inserting the bone fusion device into the desired location,wherein the bone fusion device comprises a body having an interiorcavity, one or more extendable tabs having an outward facing surface anda tab positioning assembly coupled with the one or more tabs, moving thetabs between a retracted position within the interior cavity and anextended position extending out of the cavity with an extensionpositioning element of the tab positioning assembly and adjusting theangle of the outward facing surface with respect to the body with anangle positioning element of the tab positioning assembly. In someembodiments, the movement of the tabs between the retracted position andthe extended position is independent of the adjustment of the angle ofthe outward facing surface with respect to the body. In someembodiments, the movement of the tabs between the retracted position andthe extended position and the adjustment of the angle of the outwardfacing surface with respect to the body occur simultaneously.

Yet another aspect of the present application is directed to a bonefusion assembly for insertion into a desired location. The bone fusionassembly comprises a body having a front end, a back end, an interiorcavity, an exterior surface and one or more canals positioned along theexterior surface, one or more hollow members positioned at leastpartially within the canals, one or more tabs configured to selectivelymove between a retracted position within the interior cavity and anextended position extending out of the body in order to brace the bonefusion device in the desired location, a positioning element positionedwithin the interior cavity and accessible from exterior to the bodythrough the front end and a plurality of extending blocks coupled withthe positioning element and in contact with the one or more tabs suchthat moving the positioning element causes the extending blocks to movethe one or more tabs between the extended position and the retractedposition. In some embodiments, the canals are accessible from the frontend and extend through the a plane perpendicular to the front end. Insome embodiments, the canals extend from the exterior surface to theinterior cavity. In some embodiments, the hollow members comprise one ormore apertures and are filled with bone grafting material. In someembodiments, at least one of the hollow members is curved and extendsfrom within one of the canals into the interior cavity of the body.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A illustrates a top perspective view of the bone fusion deviceaccording to some embodiments.

FIG. 1B illustrates a top cutout view of the bone fusion deviceaccording to some embodiments.

FIG. 2 illustrates a side perspective view of the bone fusion deviceaccording to some embodiments.

FIG. 3 illustrates a cross-sectional view of components of the bonefusion device according to some embodiments.

FIG. 4A illustrates a cross sectional view of the bone fusion devicewith the plates compacted according to some embodiments.

FIG. 4B illustrates a cross sectional view of the bone fusion devicewith the plates extended according to some embodiments.

FIG. 5 illustrates a profile view of a bone fusion device having asingle plate extension/retraction mechanism according to someembodiments.

FIG. 6A illustrates a top view of a bone fusion device according to someembodiments.

FIG. 6B illustrates a top view of a bone fusion device according to someembodiments.

FIG. 6C illustrates a top view of a bone fusion device according to someembodiments.

FIG. 6D illustrates a top and perspective view of a bone fusion deviceaccording to some embodiments.

FIG. 6E illustrates a top and perspective view of a bone fusion deviceaccording to some embodiments.

FIG. 6F illustrates a top and perspective view of a bone fusion deviceaccording to some embodiments.

FIG. 6G illustrates a perspective view of a bone fusion device accordingto some embodiments.

FIG. 7 illustrates a cross sectional perspective view of a bone fusiondevice having an angled positioning components according to someembodiments.

FIG. 8 illustrates a flowchart directed to a method of using a bonefusion device according to some embodiments.

FIG. 9 illustrates a flowchart directed to a method of using a bonefusion device according to some embodiments.

FIG. 10A illustrates a lateral view of a bone fusion system according tosome embodiments.

FIG. 10B illustrates a lateral view of a bone fusion system according tosome embodiments.

FIG. 10C illustrates a lateral view of a bone fusion system having oneor more channels according to some embodiments.

FIG. 11 illustrates a detailed perspective view of a device fasteneraccording to some embodiments.

FIG. 12 illustrates a detailed perspective view of a body fasteneraccording to some embodiments.

FIG. 13 illustrates a flowchart directed to a method of using the bonefusion system according to some embodiments.

FIG. 14A illustrates a frontal view of a bone fusion device according tosome embodiments.

FIG. 14B illustrates a top view of a bone fusion device according tosome embodiments.

FIG. 14C illustrates a perspective top view of a bone fusion deviceaccording to some embodiments.

FIG. 15 illustrates a frontal view of a bone fusion device according tosome embodiments.

FIG. 16 illustrates a flowchart directed to a method of using the bonefusion device according to some embodiments.

FIG. 17 illustrates a flowchart directed to a method of using the bonefusion system according to some embodiments.

FIG. 18A illustrates a side profile view of a bone fusion deviceaccording to some embodiments.

FIG. 18B illustrates a side profile view of a bone fusion deviceaccording to some embodiments.

FIG. 19 illustrates a flowchart directed to a method of using the bonefusion device according to some embodiments.

FIG. 20A illustrates a perspective view of a bone fusion systemaccording to some embodiments.

FIG. 20B illustrates a perspective view of a bone fusion systemaccording to some embodiments.

FIG. 21 illustrates a perspective view of a bone grafting material bagaccording to some embodiments.

FIG. 22 illustrates a flowchart directed to a method of using the bonefusion system according to some embodiments.

FIG. 23A illustrates a frontal view of a bone fusion device according tosome embodiments.

FIG. 23B illustrates a side view of a bone fusion device according tosome embodiments.

FIG. 23C illustrates a top view of an elongated member inserted within acanal of a bone fusion device according to some embodiments.

FIG. 23D illustrates a frontal and profile view of an elongated memberaccording to some embodiments.

FIG. 24 illustrates a flowchart directed to a method of using the bonefusion system according to some embodiments.

FIG. 25 illustrates a bone fusion device having a rachet mechanismaccording to some embodiments.

FIG. 26A illustrates a cross sectional view of a bone fusion devicehaving a lock mechanism according to some embodiments.

FIG. 26B illustrates a side view of a lock mechanism according to someembodiments

FIG. 27A illustrates a side cross sectional view of a bone fusion devicehaving an oblong locking mechanism according to some embodiments.

FIG. 27B illustrates a frontal view of a body of the bone fusion deviceand the oblong locking mechanism according to some embodiments.

FIG. 27C illustrates a frontal view of a bone fusion device having anoblong locking mechanism in the unlocked position according to someembodiments.

FIG. 27D illustrates a frontal view of a bone fusion device having anoblong locking mechanism in the locked position according to someembodiments.

FIG. 27E illustrates a frontal view of a bone fusion device having anoblong locking mechanism in the unlocked position according to someembodiments.

FIG. 27F illustrates a frontal view of a bone fusion device having anoblong locking mechanism in the locked position according to someembodiments.

DETAILED DESCRIPTION

In the following description, numerous details and alternatives are setforth for purpose of explanation. However, one of ordinary skill in theart will realize that the invention can be practiced without the use ofthese specific details. For instance, the figures and description belowoften refer to the vertebral bones of a spinal column. However, one ofordinary skill in the art will recognize that some embodiments of theinvention are practiced for the fusion of other bones, including brokenbones and/or joints. In other instances, well-known structures anddevices are shown in block diagram form in order not to obscure thedescription of the invention with unnecessary detail.

FIGS. 1A and 1B illustrate a top perspective and cutout view of the bonefusion device 100 according to some embodiments. As shown, the bonefusion device 100 has a substantially rectangular shape and has two endfaces. The bone fusion device 100 is able to be constructed from a highstrength biocompatible material, such as titanium, which has thestrength to withstand forces in the spine that are generated by apatient's body weight and daily movements. Alternatively, part of all ofthe bone fusion device 100 is able to be constructed from one or more ofthe group consisting of high strength biocompatible material or apolymer such as PEEK, PEKK, and other polymeric materials know to bebiocompatible and having sufficient strength. In some embodiments, thematerials used to construct the bone fusion device include usingadditives, such as carbon fibers for better performance of the materialsunder various circumstances. The base biocompatible material is oftentextured or coated with a porous material conducive to the growth of newbone cells on the bone fusion device 100. The bone fusion device 100 isable to have several conduits or holes 120 (also see FIG. 2) whichpermit the bone graft material to be inserted into the device 100 and tocontact the vertebral bone before or after the device 100 has beeninserted between the vertebrae of the patient. The bone graft materialand the surface texturing of the device 100 encourage the growth andfusion of bone from the neighboring vertebrae. The fusion and healingprocess will result in the bone fusion device 100 aiding in the bridgingof the bone between the two adjacent vertebral bodies of the spine whicheventually fuse together during the healing period.

As further illustrated in FIGS. 1A and 1B, plates 130 are located onopposing sides of the bone fusion device 100. The plates 130 are shapedso that their outer surface is substantially flush with the frame 114 ofthe bone fusion device 100 in a nonextended position. Internally, theplates 130 have a full or partial central rib 124 and an angled innersurface. Specifically, the central rib 124 is configured to providefurther outer surface area and structural support to the plates 130.Further, each plate 130 is shaped such that one or more angled surfaces123 of the plate 130 for extending the plate 130 have end thicknessesthat are larger than their middle thicknesses such that the thickness ofthe angled surfaces 123 gradually increases while going from the middleto the ends of the plate 130. A positioning component 108 within theframe 114 of the bone fusion device 100 comprises a positioning aperture134, a first screw 102 and a second screw 104 coupled together (seeFIGS. 4A and 4B). The positioning aperture 134 is configured to receivea drive/engaging mechanism 808 of a tool 602 (see FIGS. 6A-6G and 8)such that the tool 602 is able to rotate or otherwise manipulate thepositioning component 108. The positioning aperture 134 is able tocomprise numerous shapes and sizes as are well known in the art. Thefirst screw 102 is threaded opposite of the second screw 104. Forexample, if the first screw 102 is left threaded, the second screw 104is right threaded or vice-versa. Furthermore, the first screw 102 (seeFIG. 2) is of a slightly different size than the second screw 104. Thepositioning component 108 is coupled to a first extending block 110 anda second extending block 112, each having a pair of rib slots 126configured to receive the central ribs 124 of the plates 130 (see FIG.1B). Specifically, the rib slots 126 are sized such that they permit thecentral ribs 124 to slide into and out of the slots 126 (depending onthe position of the blocks 110, 112) such that when positioned withinthe slots 126, the blocks 110, 112 are able to support the plates 130against torsional forces by holding and supporting the central ribs 124.Further, the first extending block 110 is coupled to the first screw 102and the second extending block 112 is coupled to the second screw 104,and the first extending block 110 and the second extending block 112 arepositioned in the middle of the bone fusion device 100 in the compactposition. When the positioning component 108 is turned appropriately,the extending blocks 110 and 112 each travel outwardly on theirrespective screws 102 and 104. As the extending blocks 110 and 112travel outwardly, they push the plates 130 outward and the central ribs124 slide within the rib slots 126. In other words, the inner platesurface 123 when in contact with the extending blocks 110, 112 act insuch a manner so as to push the respective plates 130 apart.Specifically, the angled surfaces 111 of each extending block 110, 112are able to be in contact with the plate surfaces 123 and the center ribsurface 121 is in contact with the extending block slot surface 125.Thus, the plates 130 will be fully extended when the extending blocks110 and 112 reach the opposite ends of the screws 102, 104. To retractthe plates 130, the positioning device 108 is turned in the oppositedirection and the extending blocks 110 and 112 will each travel back tothe middle on their respective screws 102 and 104 with the central ribs124 within the rib slots 126 enabling the plates 130 to move into theretracted position due to gravity or another downward force. When theextending blocks 110 and 112 are positioned in the middle of the bonefusion device 100, the plates 130 are compact and are within the frame114 of the bone fusion device 100. In some embodiments, the extendingblocks 110 and 112 are coupled to the plates 130 such that they applythe needed downward force to retract the plates. Alternatively, theplates 130 are able to be biased with a biasing mechanism that appliesthe downward force needed to cause the plates 130 to retract whenenabled by the position of the extending blocks 110, 112. For example,one or more springs are able to be coupled to the plates 130, whereinthe springs apply a retraction biasing force to the plates 130 thatcausing the plates to retract when enabled by the extending blocks 110,112.

It is contemplated that the operation of the device 100 is able to bereversed such that the plates 130, extending blocks 110, 112, andpositioning components 108 are configured such that the extending blocks110, 112 travel inwardly to extend the plates 130 into the extendedposition and travel outwardly to retract the plates 130 into the compactposition. Further, it is contemplated that the positioning component 108is able to be a non-rotational or other type of force generatingmechanism that is able to move the extending blocks 110, 112. Forexample, the positioning component 108 is able to be a mechanism were anon-rotational movement (e.g. in/out of the device 100) causes themovement of the extending blocks 110, 112. In any case, the nonextendedplates 130 of the bone fusion device 100 provide a compact assembly thatis suitable for insertion into the patient's body through a open, orminimally invasive surgical procedure. As used herein, an open or aminimally invasive procedure comprises a procedure wherein a smallersurgical incision is employed as compared to the size of the incisionrequired for conventional invasive surgery, for example, arthroscopicprocedures. Moreover, minimally invasive procedures minimize oreliminate the need for excessive retraction of a patient's tissues suchas muscles and nerves, thereby minimizing trauma and injury to themuscles and nerves and further reducing the patient's recovery time.

As the positioning component 108 is rotated causing the extending blocks110 and 112 to move closer to the ends of the respective screws 102 and104, the extending blocks 110 and 112 push the plates 130 outwardcausing the plates 130 to assert pressure against surrounding bones andsecuring the bone fusion device 100 in place. When the extending blocks110 and 112 reach as close to the end of the positioning components 108as allowed, the plates 130 are fully extended. Furthermore, since theextending blocks 110 and 112 travel along the positioning components108, along the threads of the screws 102 and 104, very precise positionsof the plates 130 are able to be achieved. The plates 130 are able tohave serrated edges or teeth 136 to further increase the bone fusiondevice's gripping ability and therefore ability to be secured in placebetween the bones for both a long-term purchase and a short-termpurchase. In some embodiments, the serrated edges or teeth 136 are ableto be in a triangular or form a triangular wave formation as shown inFIG. 3. Alternatively, the serrated edges or teeth 136 are able to befilleted, chamfered, or comprise other teeth shapes or edge waves as arewell known in the art.

To secure the bone fusion device 100 in place, a user generally utilizesan insertion instrument such as a screw driver to turn the positioningcomponents 108. Screw drivers unfortunately have the ability to slip outof place. When performing surgery near someone's spine, it is preferableto prevent or at least minimize the slipping ability. Further, it isnecessary to ensure that the surgeon is able to precisely place andcontrol the device via a robust connection to the device. To do so,channels 122 having gripping apertures 128 are implemented to receivegripping fingers of a tool/insertion instrument (not shown) such thatthe tool cannot slip out of place during operation. Specifically, thechannels 122 are sized to receive the fingers to prevent the tool frommoving laterally with respect to the head of the positioning components108 and the gripping apertures 128 are sized to receive the fingertipsof the fingers of the tool such that the fingers (and tool) are unableto unintentionally be pulled out of the channels 122 (and positioningcomponents 108). In some embodiments, the channels 122 are offset suchthat when facing the positioning aperture 134, one channel 122 isproximate the top left of the device 100 and the other channel 122 isproximate the bottom right of the device 100. Alternatively, thechannels 122 are able to positioned on other portions of the frame 114.In operation, a surgeon causes the fingers of the tool to spread as theare inserted into the channels 122, and then the surgeon causes thefingers to clamp together inserting the fingertips of the fingers intothe gripping apertures 128 and fully securing the tool onto the device100. Thus, the tool is unable to slip out of place and is only able tobe removed upon the spreading of the fingers such that the fingertipsare removed from the apertures 128 and the fingers are removed from thechannels 122. Furthermore, if the device 100 is next to relativelyimmovable tissue (e.g. bone, ligament or tendon under load), then thisdevice 100 will still be able to disengage, whereas one that relies onclamping by bending two rods together will not work if one of the rodsis restricted by the relatively immovable tissue.

FIG. 2 illustrates a side perspective view of the bone fusion device 100according to some embodiments. The bone fusion device 100 utilizes thepositioning components 108 comprising the first screw 102 and the secondscrew 104 to move the first extending block 110 and the second extendingblock 112 outwardly from the middle of the bone fusion device 100towards its ends. The positioning component 108 is held in place butpermitted to turn utilizing one or more first pins 116. The one or morefirst pins 116 are secured within a retaining groove 106 (FIG. 3) of thepositioning component 108. The extending blocks 110 and 112 force theplates 130 to either extend or retract depending on where the extendingblocks 110 and 112 are positioned. As described above, the plates 130are able to have serrated edges or teeth 136 to further increasegripping ability. The plates 130 are each coupled to the frame 114 ofthe bone fusion device 100 by one or more pin slots 132 (FIGS. 3 and 4A)and one or more second pins 118 wherein the one or more second pins 118fit within the one or more pin slots 132 and are able to travel alongthe interior of the one or more pin slots 132. In some embodiments, eachplate 130 is secured with a single second pin 118 and pin slot 132.Alternatively, one or more of the plates 130 are able to have multiplesecond pins 118 and pin slots 132. In some embodiments, the multiple pinslots 132 are able to be positioned at the corners of the plates 130similar to the single pin slot 132 shown in FIG. 3. In some embodiments,the multiple pin slots 132 of plates 130 are symmetric such that anyplate 130 is able to be placed on the top or bottom of the bone fusiondevice 100. Alternatively, the pin slots 132 of the plates 130 are ableto be positioned anywhere on the plate 130 and/or be positionedasymmetrically. The holes/conduits 120 within the plates 130 allow thebone graft material to contact the vertebral bone after the device 100has been inserted between the vertebrae of the patient. A set ofholes/conduits 120 within the frame 114 also allow bone graft materialto be inserted within the bone fusion device 100 after the bone fusiondevice 100 has been placed. The channels 122 having gripping apertures128 implemented to receive a tool are shown as well. Alternatively, thegripping apertures 128 are able to be omitted.

FIG. 3 illustrates a cross-sectional view of components of the bonefusion device 100 according to some embodiments. As described above, thepositioning component 108 comprises a first screw 102 and a second screw104 wherein the first screw 102 is threaded differently than that of thesecond screw 104. Furthermore, the first screw 102 is of a slightlydifferent size than the second screw 104. For example, in someembodiments the first screw 102 is an 8-32 screw and the second screw isa 6-32 screw. A retaining groove 106 is utilized to secure thepositioning component 108 in place. In some embodiments, the retaininggroove 106 is positioned opposite the end of the positioning component108 having the positioning aperture 134. To ensure that the tool doesnot slip while turning the positioning component 108, the channels 122having fingertip gripping apertures 128 are utilized to secure the toolas described above. Alternatively, the fingertip gripping apertures 128are able to be omitted and the channels 122 are able to secure the toolas described above. A first extending block 110 and a second extendingblock 112 are utilized with the positioning component 108 to extend andcompact one or more of plates 130. The first extending block 110 has aninternal opening and threading to fit around the first screw 102. Thesecond extending block 112 has an internal opening and threading to fitaround the second screw 104. The frame 114 of the bone fusion device 100contains a set of holes/conduits 120 within the frame 114 for allowingbone graft material to be inserted. Furthermore, one or more first pins116 secure the positioning component within the frame 114. One or moresecond pins 116 in conjunction with one or more pin slots 132 secure theplates 130 to the frame 114.

FIG. 4A illustrates a cross sectional view of the bone fusion device 100with the plates retracted according to some embodiments. When theextending blocks 110 and 112 are positioned in the middle of thepositioning component 108 with the first screw 102 and the second screw104, the plates 130 are positioned within the frame 114 of the bonefusion device 100 with the central ribs 124 slid within the rib slots126. The retaining groove 106 holds the positioning component 108 inplace with one or more first pins 116. The plates 130 are coupled to theframe 114 of the bone fusion device 100 using the one or more slots 132and the one or more second pins 118 wherein the one or more second pins118 fit within the one or more slots 132 and are able to travel/slidealong the interior of the one or more slots 132.

FIG. 4B illustrates a cross sectional view of the bone fusion device 100with the plates extended according to some embodiments. As shown in FIG.4A, the bone fusion device 100 is compressed/contracted when theextending blocks 110 and 112 are in the middle of the bone fusion device100. As a user turns the positioning component 108 via the positioningaperture 134, the extending blocks 110 and 112 gradually move outwardfrom the middle. If the user turns the positioning component 108 in theopposite direction, the extending blocks move back towards the middle.As the extending blocks 110 and 112 are moving outward, the central ribs124 slide out of the rib slots 126 and the extending blocks 110, 112push on the plates 130. Alternatively, the central ribs 124 and/or ribslots 126 are able to be configured such that the central ribs 124 arefully within the rib slots 126, fully removed from the rib slots 126, orsomewhere in between at any point along the path of the extending blocks110, 112 from the center of the device to the ends of the device. Theplates 130 extend because the extending blocks 110 and 112 exert forceagainst the angled plates 130 outwardly as shown by the arrows 140. Whenthe extending blocks 110 and 112 are positioned near the ends of thebone fusion device 100, the plates 130 extend beyond the frame 114 ofthe bone fusion device 100 and ultimately secure the bone fusion device100 between two bones. With the plates 130 coupled to the frame 114 ofthe bone fusion device 100 by the one or more slots 132 and the one ormore second pins 118, the plates 130 are able to extend beyond the frame114 of the bone fusion device 100 as the one or more second pins 118travel within the interior of the one or more slots 132.

In operation, the bone fusion device 100 is initially configured in acompact position such that the extending blocks 110, 112 are located inthe middle of the bone fusion device 100 thereby allowing the plates 130to rest within the frame 114 of the bone fusion device 100. The compactbone fusion device 100 is then inserted into position within thepatient. The surgeon is able to then the expand the bone fusion device100 by rotating the positioning component 108 which moves the extendingblocks 110, 112 towards the opposing ends of the bone fusion device100—one near the head of the positioning component 108 and the othertowards the tail of the positioning component. As the extending blocks110, 112 move away from the middle, the plates 130 are pushed outwardlyfrom the pressure of the extending blocks 110, 112 against the angledplates 130. Initially, the central ribs 124 of the plates 130 remain atleast partially within the rib slots 126 of the extending blocks 110,112 such that the blocks 110, 112 are able to resist torsional forces onthe plates 130 and/or device 100. Gradually, the central ribs 124 slideout of the rib slots 126 as the extending blocks 110, 112 approach theends of the positioning component 108. Alternatively, the central ribs124 are able to be configured such that they remain at least partiallywithin the rib slots 126 as the extending blocks 110, 112 approach theends of the positioning component 108. Eventually the extending blocks110, 112 exert a satisfactory force between the extended plates 130 andthe bones to be fused. At that point the bone fusion device 100 is ableto remain in place. Thereafter, material for fusing the bones togetheris inserted through the holes and openings 120 within the bone fusiondevice 100. Alternatively, the insertion of the material for fusing thebones together is able to be omitted.

FIG. 5 illustrates a bone fusion device 500 having a single plateextension/retraction mechanism according to some embodiments. The bonefusion device 500 shown in FIG. 5 is substantially similar to the bonefusion device 100 except for the differences described herein. Inparticular, the bone fusion device 500 comprises a half frame 514, oneor more half extending blocks 510, 512, a plate 530 and positioningcomponent 508. Similar to the bone fusion device 100, the half extendingblocks 510, 512 are coupled around the positioning component 508 suchthat when the positioning components 508 are turned, the blocks 510, 512move outwards causing the plate 530 to move to the extended position.The half frame 514 comprises a plate aperture (see FIG. 1A) forreceiving the plate 530 and a solid floor 538 opposite the plateaperture. In some embodiments, the floor 538 is able to have one or morefloor holes/conduits for receiving/distributing grafting material intoand out of the device 500. In some embodiments, the device 500 is sizedsuch that when the plate 530 is in the compact/retracted position thedistance between the top of the plate 530 and the floor 538 is less thanor equal to 5 mm, and when the plate 530 is in the extended position thedistance between the top of the plate 530 and the floor 538 is less thanor equal to 7 mm. Alternatively, the device 500 is sized such that whenthe plate 530 is in the compact/retracted position the distance betweenthe top of the plate 530 and the floor 538 is in the range of 5 mm to 13mm and when the plate 530 is in the extended position the distancebetween the top of the plate 530 and the floor 538 is in the range of 7mm to 22 mm. Alternatively, other sizes of the device 500 arecontemplated as are well known in the art. Thus, by including only asingle plate 530, the height of the device 500 is able to be minimized.As a result, the bone fusion device 500 enables surgeons to use smallerincisions as well as to fit the bone fusion device 500 into smallerplaces and increasing the versatility of the device 500. Additionally,it should be noted that the single plate extension/retraction mechanismdescribed in FIG. 5 is able to replace each of the dual or multipleplate extension/retraction mechanisms described herein wherein thedevices having dual plate extension/retraction mechanisms areessentially halved (except for the positioning component) such that onlyone plate is remaining.

FIGS. 6A-6G illustrate top and perspective views of a bone fusion device600 according to some embodiments. Although one or more of thecomponents discussed above are omitted, the bone fusion devices 600shown in FIGS. 6A-6G are substantially similar to the bone fusion device100 except for the differences described herein. As shown in FIGS.6A-6G, the bone fusion device 600 comprises a positioningcomponent/element 608 one or more plates 630 and a frame 614.Specifically, the frame 614 comprises an oval shaped (FIG. 6A), kidneyshaped (FIG. 6B), round shaped (FIG. 6C), rectangular shaped (FIG. 6D),banana shaped (FIG. 6E) or otherwise shaped (FIG. 6F) top/bottom viewprofile such that the shape of the top/bottom view profile of the frame614 is substantially similar to the shape of the horizontalcross-section or top/bottom view profile of one or more vertebrae.Alternatively, the top/bottom view profile of the frame 614 is able tocomprise one or more other shapes that substantially match top/bottomview profiles of bones that are to be fused to the bone fusion device600. Alternatively, the top profile of the plates 630 are able to beshaped as described herein, wherein the frame 614 remains the standardshape as described above. In some embodiments, the top view profile ofthe plates 630 are shaped substantially similar to the top/bottomprofile of the frame 614. For example, as shown in FIGS. 6D-6F, theplates 630 have rounded edges to match the perimeter of the frames 614.Alternatively, the top profile of the plates 630 is able to compriseother shapes as are well known in the art. In some embodiments, the topview profile shapes of the frame 614 are between 15 and 25 mm along theanterior/posterior axis and between 20 and 45 mm along the lateral axis.Alternatively, other dimensions are envisioned. For example, for bonefusion devices designed for cervical spinal bones, the frame 614 is ableto be less than 15 mm along the anterior/posterior axis and less then 20mm along the lateral axis. Alternatively, the frame 614 is able to be 55mm or longer along the lateral axis (typically for extreme laterallumbar interbody fusion). In some embodiments, as shown in FIG. 6G, thepositioning components 608 are able to be non-parallel with theelongated lateral dimension/axis 615 of the frame 614 and/or tabs 630.As a result, the bone fusion device 600 provides the advantage ofsubstantially matching the horizontal profiles of the bones to be fused,thereby increasing the strength and efficiency of the fusion process.Further, the profile shapes provide the advantage of enabling a user toselect a bone fusion device 600 with a top profile shape whoseorientation matches the insertion orientation of the operation. Further,the angles at which the positioning components 608 are oriented withrespect to the elongated axis 615 of the frame 614 is able to beselected to match the angle of access provided by a desired operation.As a result, the bone fusion device 600 does not need to be turned to bein the proper orientation between the bones of the patient whether theprocedure is anterior, posterior, lateral, far-lateral or transforaminallumbar interbody fusion.

FIG. 7 illustrates a cross sectional perspective view of a bone fusiondevice 700 having an angled positioning components according to someembodiments. The bone fusion device 700 shown in FIG. 7 is substantiallysimilar to the bone fusion device 100 except for the differencesdescribed herein. Specifically, as shown in FIG. 7, the bone fusiondevice 700 comprises a frame 714 housing one or more extending blocks710, 712, positioning components 708 and angled positioning components742. The angled positioning components 742 comprise a positioning shaft750, one or more screw gears 748, one or more shaft gears 746 and anangled positioning aperture 744. The screw gear 748 is coupled to thepositioning components 708 such that when the screw gear 748 is rotated,the positioning components 708 are also rotated. One end of thepositioning shaft 750 is coupled to the shaft gear 746 and the other endof the positioning shaft 750 is coupled to the angled positioningaperture 744 such that a drive mechanism (not shown) is able to rotatethe shaft gear 746 (via the positioning shaft 750) by rotating theangled positioning aperture 744. Further, the shaft gear 746 and thescrew gear 748 are in communication with each other such that when adrive mechanism rotates the shaft gear it is also able to rotate thepositioning components 708. Alternatively, the angled positioningcomponents 742 are able to comprise other types of frictional torsiontransfer systems as are well known in the art.

Thus, a user is able to control the extension and retraction of theplates (not shown) by rotating the angled positioning components 742. Insome embodiments, the angled positioning components 742 is positionedsuch that the shaft 750 is substantially perpendicular to thepositioning components 708. Alternatively, the angled positioningcomponents 742 is able to be positioned such that the shaft 750 formsany angle between 0 and 90 degrees with the positioning components 708.In some embodiments, the angled positioning aperture 744 is able toreplace the positioning aperture 134 such that the positioning element708 is only able to be rotated using the angled positioning aperture744. Alternatively, the bone fusion device 700 comprises both apositioning aperture 734 and the angled positioning aperture 744 suchthat either aperture 734, 744 is able to be used to position the one ormore plates 730. In some embodiments, the shaft gears 746 and/or screwgears 748 comprise disk gears that interlock via interlocking teeth.Alternatively, the shaft gears 746 and/or screw gears 748 are able tocomprise one or more of disk gears, beveled gears, worm gears and/orother types of gears as are well known in the art. Thus, the bone fusiondevice 700 provides the advantage of allowing the plates 730 to beextended from angles other than parallel to the positioning components708, which is critical in procedures where the device 700 is to beinserted from varying angles such as, for example, anterior lumbarinterbody fusion, lateral lumbar interbody fusion or transforaminallumbar interbody fusion. Additionally, it should be noted that thedifferences to the bone fusion device 700 described in FIG. 7 are ableto be incorporated with and/or replace components of each of the otherbone fusion devices described herein.

A method of using the bone fusion device 600 according to someembodiments is illustrated by the flow chart in FIG. 8. A user selectsthe shape of the top profile of the frame 614 of a bone fusion device600 based on a type of lumbar interbody fusion to be performed at thestep 802. In some embodiments, the user selects an elongated oval shapeframe 614 based on the type being extreme lateral lumbar interbodyfusion. Alternatively, the user selects a kidney or rounded shape frame614 based on the type being anterior lumber interbody fusion. In someembodiments, the user selects the shape of the top profile of the frame614 of a bone fusion device 600 based on a horizontal profile of thebone or bones to be fused to the device. For example, a bone fusiondevice is able to be selected because the device 600 has a top profileshape that substantially matches the shape of the horizontal profile ofa cervical spinal bone or bones to be fused with. The user inserts theselected bone fusion device 600 in between the desired bones accordingto the type of lumbar interbody fusion to be performed at the step 804.In some embodiments, the bone fusion device 600 is able to be positionedoffset from the center of the adjacent bones and/or discs. Thus, themethod of using the bone fusion device 600 provides the advantage ofenabling a user to select a top profile of the frame 614 of the bonefusion device 600 based on the type of procedure thereby increasing theeffectiveness of the procedure. Additionally, it should be noted thatone or more of the steps of the above method are able to be omitted orcombined with the other methods described herein.

A method of using the bone fusion device 700 according to someembodiments is illustrated by the flow chart in FIG. 9. A user selects abone fusion device 700 having angled positioning components 742 at adesired angle relative to the positioning components 708 based on a typeof lumbar interbody fusion to be performed at the step 902. In someembodiments, the user selects angled positioning components 742 that aresubstantially parallel to the positioning components 708 based on thetype being anterior lumbar interbody fusion. In some embodiments, theuser selects a bone fusion device 700 having angled positioningcomponents 742 at a desired angle relative to the positioning components708 based on the shape of the top profile of the frame 614 of a bonefusion device 600 and the type of lumbar interbody fusion to beperformed. The user inserts the selected bone fusion device 700 inbetween the desired bones according to the type of lumbar interbodyfusion to be performed at the step 904. Thus, the method of using thebone fusion device 700 provides the advantage of enabling a user toselect a bone fusion device 700 having angled positioning components 742that form a desired angle with the positioning components 708 of thebone fusion device 700 based on the type of procedure thereby increasingthe effectiveness of the procedure. Additionally, it should be notedthat one or more of the steps of the above method are able to be omittedor combined with the other methods described herein.

FIG. 10A illustrates a lateral view of a bone fusion system 1000according to some embodiments. As shown in FIG. 10A, the bone fusionapparatus 1000 comprises one or more bone fusion device bodies 1002having one or more plates 1008 and one or more device fasteners 1006A,and a replacement body 1004 having one or more body fasteners 1006B.Alternatively, the bone fusion devices 1002 are able to comprise thebody fasteners 1006B and the replacement body 1004 is able to comprisethe device fasteners 1006A. The one or more device fasteners 1006A arecoupled to the top of one or more of the plates 1008 and the one or morebody fasteners 1006B are coupled to the top and/or bottom of thereplacement body 1004. As a result, a user is able to detachably coupleone or more of the devices 1002 to the replacement body 1004 bydetachably coupling the device fasteners 1006A to the body fasteners1006B. In some embodiments, a plurality of replacement bodies 1004 aredirectly coupled together, wherein bone fusion devices 1002 are coupledto one or both of the unoccupied ends of the directly coupledreplacement bodies 1004. In some embodiments, the replacement bodies1004 are able to have varying heights such that the bodies 1004 are ableto singly or in combination replace one or more bones of a variety ofheights. For example, the replacement bodies 1004 are able to be usedfor replacing bones when performing a corpectomy due to cancer orinfection. In some embodiments, the fasteners 1006A, 1006B comprise arail/slot fastening mechanism.

Alternatively, the fasteners 1006A, 1006B are able to comprise othertypes of permanent or detachable fasteners as are well known in the art.In some embodiments, the replacement body 1004 is hollow. In someembodiments, the bone fusion device bodies 1002 comprise one or morefasteners 1006A, 1006B in addition to or instead of the fasteners 1006A,1006B on the plates 1008. In some embodiments, the replacement body 1004has a top profile that is substantially similar to the horizontalprofile of the bone that is to be replaced. Alternatively, thereplacement body 1004 is able to be solid and/or have other top profileshapes as are well known in the art. The one or more bone fusion devices1002 are able to be substantially similar to the bone fusion device 100except for the differences described herein.

Alternatively, as shown in FIG. 10B, the replacement body 1004 is ableto be omitted such that the system 1000 comprises a plurality of bonefusion devices 1002 coupled together directly. Specifically, as shown inFIG. 10B each of the plates 1008 of each of the bone fusion devices 1002are able to comprise either a device fastener 1006A or a body fastener1006B such that plates 1008 with a body fastener 1006B are able todirectly couple to plates 1008 with a device fastener 1006A. In someembodiments, only one of the plates 1008 of a device 1002 comprises afastener 1006A, 1006B. In some embodiments, one or more of the devices1002 comprise at least one plate 1008 having a device fastener 1006A andat least one plate 1008 having a body fastener 1006B. In someembodiments, one or more of the devices 1006 comprise a pair of plates1008 both having either a device fastener 1006A or a body fastener1006B. In some embodiments as shown in FIG. 10C, the fusion devices 1002and/or the replacement bodies 1004 are able to comprise one or morechannels 1010 such that when the fusion devices 1002 and/or replacementbodies 1004 are coupled together one or more of the channels 1010 areable to align or be in communication and thereby form one or moreelongated channels that traverses across all or part of the system 1000.In particular, the alignment and/or communication of the channels 1010enables bone grafting or other types of material to be inserted in tothe elongated channels in order to better promote bone growth and thehealing process.

FIGS. 11 and 12 illustrate detailed perspective views of the devicefastener 1006A and the body fastener 1006B, respectively, according tosome embodiments. Specifically, as shown in FIG. 11, the device fastener1006A comprises one or more slats or slots 1102 and one or more snap-fitmembers 1104 on the one or more slots 1102. As shown in FIG. 12, thedevice fastener 1006B comprises one or more rails 1202 and one or morecutouts 1204 within the one or more rails 1202. The slots 1102 are sizedsuch that they are able to slide under the rails 1202, wherein thesnap-fit members 1104 are depressed into the slot 1102 until thesnap-fit members 1104 reach the cutouts 1204 and “snap” into placewithin the cutouts 1204. As a result, the device fastener 1106A issecurely detachably coupled to the body fastener 1006B wherein theinterlocking of the rails 1202 and the slots 1102 prevent the fastenersfrom being pulled away from each other, and the snap-fit member 1104 andthe cutouts 1204 prevent the slots 1102 from sliding out from under therails 1202. Alternatively, the rails 1202 are able to comprise thesnap-fit members 1104 and the slots are able to comprise the cutouts1204. Alternatively, other locking mechanisms as are well known in theart are able to be used in combination with or in place of the snap-fitmember 1104 and/or the cutouts 1204. Thus, the bone fusion system 1000provides the advantage of enabling multiple devices 1002 to be coupledtogether via a replacement body 1004 in order to replace a degeneratedbone and the adjacent discs. Additionally, it should be noted that thedifferences to the bone fusion devices 1002 described in FIGS. 10-12 areable to be incorporated with and/or replace components of each of theother bone fusion devices described herein.

A method of using the bone fusion system 1000 according to someembodiments is illustrated by the flow chart in FIG. 13. A userselectively couples together two or more of the group consisting of bonefusion devices 1002 and replacement bodies 1004 to form a bone fusionsystem 1000 at the step 1302. In some embodiments, the number ofreplacement bodies 1004 selected to be coupled together by the user isbased on the height of the one or more bones and/or discs to bereplaced. The user inserts the bone fusion system 1000 as coupled intoposition within the patient at the step 1304. Alternatively, thecoupling of the bone fusion system 1000 is able to occur after one ormore components of the system 1000 have been inserted into and/orpositioned between the bones of the patient. Thus, the bone fusionsystem 1000 is able to provide the benefit of allowing surgeons toreplaced one or more degenerated bones of varying heights by adjustingthe height of the system 1000 and/or the component composition of thesystem 1000. Additionally, it should be noted that one or more of thesteps of the above method are able to be omitted or combined with theother methods described herein.

FIG. 14A illustrates a frontal view of a bone fusion device 1400according to some embodiments. The bone fusion device 1400 shown in FIG.14A is substantially similar to the bone fusion device 100 except forthe differences described herein. Specifically, as shown in FIG. 14A,the bone fusion device 1400 comprises a frame 1414 and one or moreplates 1430 having an angled or non-parallel top surface or top plane1402 with respect to the top plane of the frame 1414 and/or the bottomplane of the plate 1430. In some embodiments, the angles of the topsurface 1402 are along a single axis of the device 1400. For example, asshown in FIG. 14A the angles of the top surface 1402 are lateral withrespect to a frontal view, making the angles well suited for correctingdeformities such as scoliosis or other trauma repair. As anotherexample, the angles of the top surface 1402 are able to be lateral withrespect to a side view, making the angles well suited forlordosis/kyphosis adjustments. Alternatively, the angles of the topsurface 1402 are able to be along multiple axes. In some embodiments,the angles and/or the orientation of the angles of each of the plates1430 are substantially the same. Alternatively, one or more of theplates 1430 are able to have different angles and/or the orientation ofthe angles. In some embodiments, the plates 1430 are modular orinterchangeable such that a user is able to select the plates 1430 to beincluded within the device 1400 based on the desired angle and/ororientation of the angle of the top surface 1402 of the plates 1430. Insome embodiments, one or more of the plates 1430 with angled topsurfaces 1402 are rotatable such that the orientation of the angled topsurface 1402 is able to be adjusted once the plate has been extended.For example, as shown in FIGS. 14B and 14C, the plates 1430 are able tobe rotated about an axis 1404 from an initial position 1406 parallel tothe frame 1414 to a rotated position 1408 that is not parallel to theframe 1414. Thus, the orientation of the angled plates 1430 is able tobe adjusted as needed to replace the degenerated discs and/or bones. Insome embodiments, the axis 1404 is positioned at the center of theplates 1430. Alternatively, the axis 1404 is able to be off-center. Insome embodiments, one or more of the plates 1430 are able to have aplurality of axis around which the plates 1430 are able to rotate. Insome embodiments, one or more of the plates 1430 share one or more axesof rotation. Alternatively, one or more of the plates 1430 are able tohave different axis of rotation than one or more of the other plates1430. In some embodiments, the plates 1430 are unable to rotate and theorientation of the angled top surface 1402 is able to be adjusted byrotating the entire device 1400. Thus, the bone fusion device 1400provides the advantage of enabling the angle and orientation of theplates to be adjusted to correct scoliosis an other spine/bone angleirregularities. Additionally, it should be noted that the components ofthe bone fusion device 1400 described in FIGS. 14A-14C are able to beincorporated with and/or replace components of each of the other bonefusion devices described herein.

FIG. 15 illustrates a frontal view of a bone fusion device 1500according to some embodiments. The bone fusion device 1500 shown in FIG.15 is substantially similar to the bone fusion device 100 except for thedifferences described herein. Specifically, as shown in FIG. 15, thebone fusion device 1500 comprises a frame 1514, one or more plates 1530,one or more height adjusters 1508A and one or more angle adjusters1508B. The height adjusters 1508A are able to adjust the height orextension of the plates 1530 outside of the frame 1514 and the angleadjusters 1508B are able to adjust the angle of the top surface of theplates 1530 (with respect to the frame 1514). As a result, a user isable to dynamically adjust the position and/or orientation of the plates1530 from a first extended and parallel position 1502, to a secondextended and non-parallel position 1504. Specifically, this provides theadvantage of allowing a surgeon to match both the heights and the anglesneeded to replace degenerated discs and/or bones. In some embodiments,the angles and/or the orientation of the angles and/or heights of eachof the plates 1530 are able to be adjusted independently. Alternatively,adjustment of the angles and/or heights of one or more of the plates1530 is dependent on the adjustment of one or more of the other plates1530. In some embodiments, the adjustments are able to be madeautomatically or manually via mechanical means. Alternatively, theadjustments are able to be made automatically or manually viaelectrical, mechanical, hydraulic, pneumatic or other types of meanswell known in the art individually or in combination. In someembodiments, one or more of the height adjusters 1508A are substantiallythe same as the positioning components 108. Alternatively, other typesof height adjusting mechanisms are able to be used as are well known inthe art. In some embodiments, one or more of the height adjusters 1508Aand angle adjusters 1508B are able to be combined as one or more heightand angle adjusters. For example, a plurality of height adjusters 1508Aare able to independently adjust the height of a portion of theperimeter of the plates 1530 such that by raising one portion of theperimeter more or less than other portions of the perimeter, the heightadjusters 1508A are able to effectuate both height, angle andorientation of the angle adjustment. Alternatively, other forms of dualheight/angle adjustment mechanisms are able to be used as are well knownin the art. Additionally, it should be noted that the differences to thebone fusion device 1500 described in FIG. 15 is able to be incorporatedwith and/or replace components of each of the other bone fusion devicesdescribed herein.

A method of using the bone fusion device 1400 according to someembodiments is illustrated by the flow chart in FIG. 16. A user selectsone or more plates 1430 having top surfaces 1402 with desired anglesbased on the one or more bones and/or discs to be replaced at the step1602. In some embodiments, the selection comprises exchanging thecurrent plate 1430 for another plate 1430 having a differently angledtop surface 1402. The user moves the device 1400 into the desiredposition within the patient at the step 1604. The user extends theplates 1430 to the desired height such that the angled top surfaces 1402abut the desired bones for fusing to the bones at the step 1606. In someembodiments, the method further comprises the user rotating the plates1430 until the orientation of the angled top surface 1402 is as desiredsuch that the top surfaces 1402 match and/or correct the bones and/ordiscs being replaced. Alternatively, the user is able to rotate theentire device 1400 until the orientation of the angled top surface 1402matches and/or corrects the bones and/or discs being replaced. In someembodiments, the user is able to rotate the plates 1430 independent ofeach other. Thus, the bone fusion device 1400 is able to provide thebenefit of allowing surgeons to replace one or more degenerated bones ofvarying heights, angles and angle orientations by adjusting the height,angle and orientation of the angle of the top surface 1402 of the plates1430 of the device 1400. Additionally, it should be noted that one ormore of the steps of the above method are able to be omitted or combinedwith the other methods described herein.

A method of using the bone fusion system 1500 according to someembodiments is illustrated by the flow chart in FIG. 17. A user movesthe device 1500 into the desired position within the patient at the step1702. The user extends and adjusts the plates 1530 such that the plates1530 have the desired height, angle and/or angle orientation such thatthe plates 1530 abut the desired bones for fusing to the bones at thestep 1704. In some embodiments, the plates 1530 are extended and/oradjusted manually. Alternatively, the plates 1530 are able to beextended and/or adjusted automatically. In some embodiments, the plates1530 are able to be adjusted gradually. Alternatively, the plates 1530are adjusted to set preselected/predefined levels. Thus, the bone fusiondevice 1500 is able to provide the benefit of allowing surgeons toreplace one or more degenerated bones of varying heights, angles andangle orientations by adjusting the height, angle and orientation of theangle of the plates 1530 of the device 1500. Additionally, it should benoted that one or more of the steps of the above method are able to beomitted or combined with the other methods described herein.

FIGS. 18A and 18B illustrate side profile views of bone fusion devices1800 according to some embodiments. The bone fusion devices 1800 shownin FIGS. 18A and 18B are substantially similar to the bone fusion device100 except for the differences described herein. As shown in FIGS. 18Aand 18B, the bone fusion device 1800 comprises one or more plates 1830and a frame 1814. Specifically, the plates 1830 comprise substantiallynon-flat top surfaces. For example, as shown in FIG. 18A, one of theplates 1830 comprise a convex top surface 1802 and the other plate 1830comprises a concave top surface 1804. Further, as shown in FIG. 18B, theplates 1830 are able to comprise both concave and convex top surfaceportions 1802, 1804. In some embodiments, the concavities and/orconvexities of the top surface portions 1802 are formed along a singleaxis (e.g. a lateral axis) such that they form one or more undulationsalong the single axis. Alternatively, the concavities and/or convexitiesof the top surface portions 1802, 1804 are able to be formed alongmultiple axis. In some embodiments, all of the plates 1830 share thesame concavities and/or convexities of their top surface portions.Alternatively, the concavities and/or convexities of the top surfaceportions of the plates 1830 are able to vary for one or more of theplates 1830. In some embodiments, the plates 1830 are modular orinterchangeable such that a user is able to select or replace one ormore of the plates 1830 of the device 1800 with another plate 1830 basedon the top surface portions of the plates 1830. Thus, the bone fusiondevice 1800 provides the advantage of enabling a surgeon to selectplates 1830 with a top surface profile that matches and/or corrects thebones and/or discs being replaced. Additionally, it should be noted thatthe differences of the bone fusion devices 1800 described in FIGS. 18Aand 18B are able to be incorporated with and/or replace components ofeach of the other bone fusion devices described herein.

A method of using the bone fusion device 1800 according to someembodiments is illustrated by the flow chart in FIG. 19. A user selectsthe plates 1830 of a bone fusion device 1800 based on the shape of thetop surface of the plates 1830 and the shape of the surfaces to whichthe plates 1830 are to be fused at the step 1902. The user inserts thebone fusion device 1800 with the selected plates 1830 in between thedesired bones at the step 1904. Thus, the method of using the bonefusion device 1800 provides the advantage of enabling a user to select adesired top surface of the plates 1830 of the bone fusion device 1800based on the type of surface needed thereby increasing the effectivenessof the procedure. Additionally, it should be noted that one or more ofthe steps of the above method are able to be omitted or combined withthe other methods described herein.

FIGS. 20A and 20B illustrate perspective views of a bone fusion system2000 according to some embodiments. The bone fusion devices 2002 shownin FIGS. 20A and 20B are substantially similar to the bone fusion device100 except for the differences described herein. The bone fusion system2000 comprises one or more bone fusion devices 2002 and one or more bonegrafting material bags 2004. As shown in FIG. 20A, the bone graftingmaterial bags 2004 are able to be positioned and/or coupled within thebone fusion device 2002. Additionally, as shown in FIG. 20B, thematerial bags 2004 are also able to be positioned or coupled outside ofthe bone fusion device 2002. FIG. 21 illustrates a perspective view of abone grafting material bag 2004 according to some embodiments. As shownin FIG. 21, the material bag 2004 comprises a mesh frame 2102, one ormore support bars 2104, at least one opening 2106 for filling the bag2004 with bone graft material, one or more bag fasteners 2108 and one ormore bag coupling elements 2110. In some embodiments, the support bars2104, bag fasteners 2108 and/or bag coupling elements 2110 are able tobe omitted. The support bars 2104 couple to the mesh frame 2102 in orderto help the mesh frame 2102 maintain its shape. In some embodiments, theshape of the mesh frame 2102 is a cylinder (as shown in FIGS. 20A and21). Alternatively, the shape of the mesh frame 2102 is able to be a“half-moon” prism (as shown in FIG. 20B) or other shapes capable ofholding a volume of bone grafting material as are well known in the art.In some embodiments, the support bars 2104 comprise polymeric materialssuch that the support bars 2104 are able to maintain the shape of thematerial bag 2004. Alternatively, the support bars 2104 are able tocomprise other materials capable of supporting the shape of the bag 2004as are well known in the art.

The opening 2106 enables bone grating material to be packed into thebone grafting material bag 2004 and is able to vary in size based on thesize of the mesh frame 2102. The bag fastener 2108 is positioned on themesh frame 2102 such that the bag fastener 2108 is able to releasablyclose or fasten the opening 2106 shut such that bone grafting materialwithin the material bag 2004 is unable to escape through the opening2106. In some embodiments, the bag fastener 2108 comprises a hoop aroundthe opening 2106 and a cinch cord to selectively cinch closed theopening 2106. Alternatively, the bag fasteners 2108 are able to compriseother types of fastening means as are well known in the art. In someembodiments, the material bags 2004 are able to comprise a plurality ofopenings 2106 and at least one bag fastener 2108 for each opening. Thebag coupling element 2110 enables the material bag 2004 to be coupled toone or more bone fusion devices 2002 and/or other material bags 2004. Asa result, the bone fusion system 2000 provides the advantage of enablingthe user to physically pack a material bag 2004 full of bone graftingmaterial in order to maximize the amount of grafting material providedto the bones. Further, the system 2000 provides the advantage of keepingthe bone grafting material in the desired location and shape withrespect to the bones to be fused to and/or the position of the bonefusion device 2002 thereby increasing the efficiency of the bone growthand/or healing process. Additionally, it should be noted that one ormore of the components of the bone fusion system 2000 are able to beincorporated into the bone fusion system 1000 described above inreference to FIGS. 10-12 and vice versa.

A method of using the bone fusion system 2000 according to someembodiments is illustrated by the flow chart in FIG. 22. A user selectsone or more bone grafting material bags 2004 based on the shape and sizeof the material bags 2004 at the step 2202. The user fills one or moreof the selected bone grafting material bags 2004 with bone graftingmaterial at the step 2204. In some embodiments, the material bag 2004 isfilled with the bone grafting material with an implement resembling a“caulking gun.” Alternatively, the material bag 2004 is able to befilled by a packing element and/or other methods of packing bonegrafting material as are well known in the art. The user couples the oneor more material bags 2004 within and/or outside the bone fusion device2002 at the step 2206. The user moves the bone fusion system 2000 intothe desired position within the patient at the step 2208. In someembodiments, the material bags 2004 are positioned such that they abutthe bones adjacent the bone and/or disc to be replaced. Thus, the methodof using the bone fusion system 2000 provides the advantage of allowingthe bone grafting material to be packed into the material bags andkeeping the bone grafting material in the desired position and/or shapewith respect to the adjacent bones and bone fusion device 2002 such thatquicker and stronger bone fusion is promoted speeding up the healingprocess. Additionally, it should be noted that one or more of the stepsof the above method are able to be omitted or combined with the othermethods described herein.

FIGS. 23A-C illustrate a front, side and top view of a bone fusiondevice 2300 having one or more canals according to some embodiments. Thebone fusion device 2300 shown in FIGS. 23A-C is substantially similar tothe bone fusion device 100 except for the differences described herein.In particular, the bone fusion device 2300 comprises a frame 2314 havingone or more canals 2321, one or more tabs 2330 and extending tabs 2310.In some embodiments, the canals 2321 are positioned along the sides ofthe frame 2314 and a sized such that the canals 2321 are able to receiveor house a portion or all of one or more elongated members 2323 (seeFIG. 23D). Alternatively, one or more of the canals 2321 are able to bepositioned within other portions of the frame 2314 including differentangles and orientations in one or all axises of the bone fusion device2300. Alternatively, one or more of the canals 2321 are able to bepositioned within one or more of the tabs 2330. In some embodiments, thecanals 2321 extend from a central area of the frame 2314 to the front orback side of the frame 2314 such that an elongated member 2323 is ableto enter the canals 2321 from the front or back side of the frame 2314(and/or the side of the frame 2314). Alternatively, one or more of thecanals 2321 extend along the entire bone fusion device 2300 from thefront side to the back side of the frame 2314 (or vice-versa), such thatan elongated member 2323 is able to enter the canals 2321 from both oreither the front or back side of the frame 2314. Alternatively, one ormore of the canals 2321 are able to be housed entirely within an innerportion of the frame 2314 such that the canals 2321 breach neither thefront nor the back side of the frame 2314 and the elongated members 2323are only able to enter the canals 2321 from the side of the frame 2314.

FIG. 23C illustrates a top view of an elongated member 2323 insertedwithin a canal 2321 of the bone fusion device 2300 according to someembodiments. As shown in FIG. 23C, the elongated member 2323 is curvedand extends from the front of the frame 2314 and canal 2321 to a centralportion of the frame 2314. Alternatively, the elongated members 2323 areable to be configured such that the members 2323 extend to the front,back, or other portions of the frame 2314. In some embodiments, one ormore of the elongated member 2321 are able to extend out of the canals2321 into the central cavity of the frame 2314 and/or outside of theframe 2314. For example, the members 2323 are able to be curved orotherwise shaped such that the members 2323 enter a desired portion ofthe frame 2314 while not extending out of the side of the frame 2314more than a desired distance (e.g. 1 mm). In some embodiments, thedesired portion of the frame 2314 in which the members 2323 arepositioned comprise between the extending blocks 2310 and the front orback side of the frame 2314 and in between the extending blocks 2310.Alternatively, the members 2323 are able to be configured such that themembers 2323 are able to remain entirely within the canals 2321 and/orcavity of the frame 2314. Additionally, it should be noted that one ormore of the components of the bone fusion device 2300 is able to beincorporated into the other bone fusion devices described herein.

FIG. 23D illustrates a frontal and profile view of an elongated member2323 according to some embodiments. As shown in FIG. 23D, the elongatedmember 2323 comprises a body 2325 and one or more apertures 2327. Thebody 2325 is sized such that the member 2323 is able to partially orwholly fit within the canals 2321. In some embodiments, the body 2325 isable to be tubular such that material is able to be inserted into thebody 2325 via the apertures 2327. Alternatively, the body 2325 is ableto be partially or wholly solid, wherein if the body 2325 is whollysolid the apertures 2327 are able to be omitted. Alternatively, the body2325 is able to comprise other solid or hollow shapes as are well knownin the art. As shown in FIG. 23D, the body 2325 of the elongated member2323 is substantially straight. Alternatively, the body 2325 is able tocomprise one or more curves and/or corners as are well known in the art.For example, as shown in FIG. 23C, the body 2325 is able to be curvedsuch that the member 2323 is able to curve from the canal 2321 into thecavity of the frame 2314 of the bone fusion device 2300. In someembodiments, the elongated member 2323 is able to be bendable such thatbody 2325 is able to be bended to a desired shape by a user and the body2325 will retain the desired shape. In some embodiments, the body 2325is filled with one or more of calcium triphosphate, hydroxyapatite orother materials that are constituents of bone or promote bone growth asare well known in the art. In some embodiments, the body 2325 is able tocomprise materials that are constituents of bone or promote bone growthas are well known in the art. Alternatively, the body 2325 is able tocomprise the same or similar materials to that of the bone fusion device2300. As a result, the bone fusion device 2300 and the elongated members2323 are able to be used to position bone grafting promotive materialalong the device 2300 after the bone fusion device 2300 has beenpositioned into place within a patient. This enables the bone fusiondevice 2300 to ensure that the bone fusion material is not pushed out ofplace during the extension of the tabs 2330 or other portions of theprocedure.

A method of using the bone fusion device 2300 according to someembodiments is illustrated by the flow chart in FIG. 24. A user selectsone or more elongated members 2323 based on the shape and size of theelongated members 2323 at the step 2402. Alternatively, the user selectsone or more elongated members 2323 and bends them into a desired shapeand size. The user fills one or more of the selected elongated members2323 with bone grafting material at the step 2404. The user positionsthe bone fusion device 2300 within the patient at the step 2406. Theuser inserts the one or more elongated members 2323 within and/oroutside the canals 2321 and/or frame 2314 of the bone fusion device 2300at the step 2408. Alternatively, one or more of the elongated members2323 are able to be positioned within and/or outside of the canals 2321before or during the positioning of the bone fusion device 2300 withinthe patient. Thus, the method of using the bone fusion system 2300provides the advantage of allowing the bone grafting material to bepacked into the elongated members 2323 and positioned after thepositioning of the bone fusion device 2300 within the patient. As aresult, the bone fusion device 2300 is able to prevent the elongatedmembers 2323 from being moved during the positioning of the bone fusiondevice within the patient thereby keeping the bone grafting material inthe desired position and/or shape with respect to the adjacent bones andbone fusion device 2300 such that quicker and stronger bone fusion ispromoted speeding up the healing process. Additionally, it should benoted that one or more of the steps of the above method are able to beomitted or combined with the other methods described herein.

FIG. 25 illustrates a bone fusion device 2500 having a rachet mechanismaccording to some embodiments. The bone fusion device 2500 shown in FIG.25 is able to be substantially similar to the other bone fusion devicesexcept for the differences described herein. In particular, the bonefusion device 2500 comprises a body 2502, a positioning means 2504 and arachet mechanism including a pawl 2506 and one or more gear teeth 2508on the perimeter of the positioning means 2504. As shown in FIG. 25, thepawl 2506 is positioned within a cavity 2510 of the body 2502 that isadjacent to the positioning means 2504 such that the arm of the pawl2506 is able to abut or be in communication with the one or more gearteeth 2508. As a result, the pawl 2506 is able to permit the positioningmeans 2504 to rotate in one direction while preventing the positioningmeans 2504 from rotating back in the opposite direction. Specifically,the size and/or angles of the gear teeth 2508 are able to be adjustedsuch that as the positioning means 2504 rotate in a first direction thepawl 2506 is able to slide over the gear teeth 2508 due to the angle ofthe pawl 2506 and/or the angle of a first side of the gear teeth 2508.Contrarily, if the positioning means 2504 starts to rotate in a secondor opposite direction the pawl 2506 is unable to slide over the gearteeth 2508 due to the angle of the pawl 2506 and/or the angle of asecond or opposite side of the gear teeth 2508 thereby stopping orpreventing the rotation of the positioning means in the second oropposite direction. As a result, the bone fusion device 2500 having arachet mechanism provides the benefit of ensuring that the tabs stay inplace when extended because the rachet mechanism prevents them fromretracting.

In some embodiments, the rachet mechanism comprises a release mechanism(not shown) that when activated separates or changes the dynamic of thepawl 2506 and the gear teeth 2508 such that the positioning means 2504is able to rotate in the second or opposite direction without beingstopped by the pawl 2506. Alternatively, the angle of the pawl 2506and/or gear teeth 2508 of the rachet mechanism are able to be configuredsuch that with a desired force F the positioning means 2504 is able tobe rotated in the second or opposite direction despite the presence ofthe pawl 2506. In particular, the desired force F is able to be greaterthan the maximum force that would occur on the tabs within a patientafter implantation such that the rotation in the second direction wouldonly occur if the surgeon needed to rotate the positioning means 2504 inthat direction. In some embodiments, the pawl 2506 comprises nitinol orstainless steel. Alternatively, the pawl 2506 is able to comprise othertypes of suitable materials as are well known in the art. In someembodiments, the first direction of rotation corresponds to thedirection required to extend the tabs of the device 2500 and the seconddirection corresponds to the direction required to retract the tabs ofthe device. Alternatively, the first direction is able to correspond tothe direction required to retract the tabs of the device 2500 and thesecond direction corresponds to the direction required to extend thetabs of the device.

FIG. 26A illustrates a cross sectional view of a bone fusion device 2600having a lock mechanism according to some embodiments. The bone fusiondevice 2600 shown in FIG. 26A is able to be substantially similar to theother bone fusion devices except for the differences described herein.In particular, the bone fusion device 2600 comprises a body 2602, apositioning means 2604 and a lock mechanism including a collar 2606 anda choke 2608. As shown in FIG. 26B, the collar 2606 has a thick end2605, a narrow end 2607 and a gap 2610 and the choke 2608 is configuredto fit around the narrow end 2607 of the collar 2606. As a result, ifthe choke 2608 is pushed or otherwise forced down on the collar 2606towards the thick end 2605, it causes the gap 2610 of the collar 2606 tocontract thereby continually reducing the circumference of the collar2606 as it moves until the gap 2610 is gone. Similarly, if the choke2608 is moved back toward the narrow end 2607 of the collar 2606, thegap 2610 is able to continually increase up to its original sizeincreasing the circumference of the collar 2606 as permitted by theinner circumference of the choke 2608. As shown in FIG. 26A, the lockmechanism 2606, 2608 is positioned around the end of the positioningmeans 2604 within an aperture at an end of the body 2602. As a result,when the choke 2608 causes the circumference of the collar 2606 toreduce, it causes the collar 2606 to provide a choking force on thepositioning means 2604 such that the positioning means 2604 are unableto rotate due to the friction between the collar 2606 and the surface ofthe positioning means 2604. As a result, the lock mechanism is able toprovide the benefit of enabling the positioning means and thus the tabsto be locked in place thereby reducing the risk of the tabs undesirablyretracting.

In some embodiments, the choke 2608 has threading 2612 that correspondsto threading of the body 2602 such that if the choke 2608 is rotated thethreading 2612 causes the choke 2608 to move further in or out of theaperture of the body 2602 and thereby move with respect to the collar2606 in order to lock or unlock the positioning means 2604 as describedabove. In such embodiments, the choke 2608 is able to have one or morecutouts 2614 for receiving a tool for rotating the choke 2608.Alternatively, the threading 2612 is able to act as “snap-fit” stops orridges/valleys that correspond to ridges/valleys of the body 2602 suchthat if the choke 2608 is pushed further into the aperture of the body2602 and toward the thick end 2605 of the collar 2606, the ridges of thethreading 2612 compress and then spring/snap into the valleys of thebody 2602 thereby preventing the choke 2608 from being forced back awayfrom end thick end 2605 of the collar 2606. In some embodiments, thethickness of the collar 2606 gradually changes from the narrow end 2607to the thick end 2605. Alternatively, the thickness of the collar 2606is able to change in one or more increments. For example, the thicknessis able to remain substantially constant until the next increment isreached.

FIGS. 27A-F illustrate a bone fusion device 2700 having an oblong lockmechanism according to some embodiments. The bone fusion device 2700shown in FIGS. 27A-F is able to be substantially similar to the otherbone fusion devices except for the differences described herein. Asshown in FIGS. 27A and 27B, which illustrate side cross sectional andfrontal views respectively, the bone fusion device 2700 comprises a body2702, positioning means 2704 within the body 2603 and an oblong lockingmember 2706 surrounding one end of the positioning means 2704 and havingone or more bumps 2716. The body 2702 comprises an aperture 2708 forreceiving the positioning means 2704 and the locking member 2706,wherein the aperture 2708 includes one or more notches 2712 that areable to selectively receive the one or more bumps 2716. In particular,as shown in FIG. 27B, the aperture 2708 is oblong such that it has ashort side 2710A and a long side 2710B that correspond to a short side2714A and long side 2714B of the oblong locking member 2706.

As a result, as shown in FIG. 27D, the oblong locking member 2706 isable to be rotated into a “locked” position where the short side 2714Aof the locking member 2706 is positioned within the long side 2710B ofthe aperture 2708 and the long side 2714B of the locking member 2706 ispositioned within the short side 2710A of the aperture 2708. In thislocked position, the positioning means 2704 will be unable to rotatefreely as pressure is applied to the positioning means 2704 by the longside 2714B of the locking member 2706 in the direction indicated by thearrow because the long side 2714B is under compression by the short side2710A of the aperture 2708. In particular, the force applied to thepositioning means 2704 by the locking member 2706 in the locked positionincreases the friction between the positioning means 2704 and thelocking member 2706 such that the positioning means 2704 is unable torotate. In contrast, as shown in FIG. 27C, the oblong locking member2706 is able to be rotated into an “unlocked” position where the shortside 2714A of the locking member 2706 is positioned within the shortside 2710A of the aperture 2708 and the long side 2714B of the lockingmember 2706 is positioned within the long side 2710B of the aperture2708. In this “unlocked” position, the positioning means 2704 will beable to rotate freely as little or no pressure is applied to thepositioning means 2704 by the locking member 2706 because the lockingmember 2706 is not under compression by the aperture 2708. As a result,the lock mechanism is able to provide the benefit of enabling thepositioning means and thus the tabs to be locked in place therebyreducing the risk of the tabs undesirably retracting.

In some embodiments, the oblong locking member 2706 comprises PEEK.Alternatively, the oblong locking member 2706 is able to comprise othertypes of biocompatable materials that are flexible such that they areable to be compressed and apply a stopping force to the positioningmeans 2704. In some embodiments, the notches 2712 and the bumps 2716 areconfigured such that one or more of the bumps 2716 slide into thenotches 2712 when the oblong locking member 2706 is in either the lockedor unlocked positions. In particular, in such embodiments the bumps 2716and notches 2712 are able to provide an indication that the lockingmember 2706 has been fully rotated in the locked or unlocked position aswell as preventing the oblong locking member 2706 from slipping out ofthe locked or unlocked position. In some embodiments, the oblong lockingmember 2706 comprising one or more apertures that facilitate therotation of the locking member 2706 by a tool or user.

FIGS. 27E and 27F illustrate an alternate embodiment of the bone fusiondevice 2700 having the oblong locking mechanism according to someembodiments. In particular, as shown in FIGS. 27E and 27F, the aperture2708 and the oblong locking member 2706 are ovular such that they eachhave a short dimension 2718A, 2720A and a long dimension 2718B, 2720B.As a result, when rotated into a “locked” position as shown in FIG. 27F,the positioning means 2704 is unable to rotate freely as pressure isapplied to the positioning means 2704 from both sides along the longdimension 2718B of the locking member 2706 in the direction indicated bythe arrows because the long dimension 2718B is under compression by theshort dimension 2720A of the aperture 2708. In contrast, as shown inFIG. 27E, the oblong locking member 2706 is able to be rotated into an“unlocked” position where the short dimension 2718A of the lockingmember 2706 is positioned within the short dimension 2720A of theaperture 2708 and the long dimension 2718B of the locking member 2706 ispositioned within the long dimension 2720B of the aperture 2708. Like inFIG. 27C, in this “unlocked” position the positioning means 2704 will beable to rotate freely as little or no pressure is applied to thepositioning means 2704 by the locking member 2706 because the lockingmember 2706 is not under compression by the aperture 2708. In someembodiments, the aperture 2708 comprises one or more notches 2712 thatare configured such that ends of the long dimension 2718B slide into thenotches 2712 when the oblong locking member 2706 is in the lockedpositions. In particular, in such embodiments the notches 2712 are ableto provide an indication that the locking member 2706 has been fullyrotated in the locked or unlocked position as well as preventing theoblong locking member 2706 from slipping out of the locked or unlockedposition. Alternatively, the oblong locking member 2706 is able tocomprise on or more bumps 2716 for sliding into the notches 2712 inaddition to or in lieu of the ends of the long dimension 2718B. As aresult, the lock mechanism is able to provide the benefit of enablingthe positioning means and thus the tabs to be locked in place therebyreducing the risk of the tabs undesirably retracting.

Thus, the bone fusion device, system and method described herein hasnumerous advantages. First, the bone fusion device, system and methodprovide the advantage of substantially matching the device profiles withthe horizontal profiles of the bones to be fused, thereby increasing thestrength and efficiency of the fusion process. As a result, the bonefusion device does not need to be turned to be in the proper orientationbetween the bones of the patient whether the procedure is anterior,posterior, lateral or transforaminal lumbar interbody fusion. Second,the bone fusion device, system and method provide the advantage ofallowing the plates to be extended from angles other than parallel tothe screws and/or the elongated dimension of the devices, which iscritical in procedures where the device is to be inserted from varyingangles. Further, the bone fusion device, system and method provides theadvantage of enabling multiple bone fusion devices to be coupledtogether via a replacement body in order to replace a degenerated boneand the adjacent discs. Further, the lock mechanism is able to providethe benefit of enabling the positioning means and thus the tabs to belocked in place thereby reducing the risk of the tabs undesirablyretracting. Additionally, the bone fusion device, system and methodprovides the advantage of enabling the angle and orientation of theplates to be adjusted to correct scoliosis an other spine/bone angleirregularities. Also, the bone fusion device, system and method providesthe advantage of enabling a surgeon to select plates with a top surfaceprofile that matches and/or corrects the bones and/or discs beingreplaced. Moreover, the bone fusion device, system and method providesthe advantage of enabling the user to physically pack a material bagfull of bone grafting material in order to maximize the amount ofgrafting material provided to the bones, as well as providing theadvantage of keeping the bone grafting material in the desired locationand shape with respect to the bones to be fused to and/or the positionof the bone fusion device thereby increasing the efficiency of the bonegrowth and/or healing process. Finally, the bone fusion device, systemand method provides the advantage of allowing the bone grafting materialto be packed into differently sized elongated members that are able tobe positioned partially or wholly within the bone fusion devices therebykeeping the bone grafting material in the desired position and/or shapewith respect to the adjacent bones.

The present invention has been described in terms of specificembodiments incorporating details to facilitate the understanding ofprinciples of construction and operation of the invention. Suchreference herein to specific embodiments and details thereof is notintended to limit the scope of the claims appended hereto. It will beapparent to those skilled in the art that modification may be made inthe embodiments chosen for illustration without departing from thespirit and scope of the invention. For example, it should be noted thatalthough the above bone fusion devices are described in reference to apair of extending blocks, a pair of screws, and wherein each plate isshaped such that the ends are larger than the middle, and the size ofthe plate gradually increases while going from the middle to the ends,the use of a single extending block in the above embodiments iscontemplated. Specifically, if using a single extending block, the aboveembodiments would operate the same except the positioning componentswould comprise a single screw that when engaged would cause the singleextending block to move from one end of the screw to the other endthereby exerting a force against the plates such that they move into theextended position. In such embodiments, each plate is shaped such thatone end is larger than the opposite end, and the size of the plategradually increases going from the smaller end to the larger end.

What is claimed is:
 1. A method of implanting a bone fusion device into a desired location, the method comprising: inserting the bone fusion device in the desired location, wherein the bone fusion device comprises a body having an interior cavity that houses an entire outer perimeter of each of one or more tabs, each tab of the tabs having an inner surface and a support rib, and one or more extending blocks each having a rib slot and an external surface configured to abut a portion of the inner surface of a respective tab, wherein an angle with respect to a common direction formed by the portion of the inner surface of the respective tab that abuts the external surface of the respective block is incongruent with an angle with respect to the common direction formed by an internally facing surface of the support rib that faces a bottom surface of the respective rib slot; and extending the one or more tabs in an extension direction from a retracted position within the interior cavity to an extended position at least partially outside the interior cavity by moving at least one of the extending blocks along the inner surface of the tabs such that the rib slots slide along the support ribs positioned at least partially within the ribs slots, wherein the rib slot of each of the extending blocks has a plurality of sidewalls substantially parallel to the extension direction.
 2. The method of claim 1, further comprising retracting the tabs of the bone fusion device into the retracted position before inserting the bone fusion device into the desired location.
 3. The method of claim 1, wherein moving the extending blocks comprises manipulating a positioning element of the bone fusion device coupled with the extending blocks and having a positioning aperture.
 4. The method of claim 3, further comprising securing a gripping apparatus to the bone fusion device by inserting one or more fingers of the gripping apparatus into one or more channels on an exterior surface of the body of the bone fusion device.
 5. The method of claim 4, further comprising securing the fingers within the channels by inserting one or more fingertips of the fingers into one or more apertures of the channels.
 6. The method of claim 5, wherein the channels are positioned along the exterior surface on a plane perpendicular to the positioning aperture such that the fingers of the gripping apparatus are able to enter the channels by moving parallel to the plane.
 7. The method of claim 1, wherein an outward facing surface of the tabs comprises a plurality of teeth such that the outward facing surface is serrated.
 8. The method of claim 1, further comprising selecting a bone fusion device having a body with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having bodies with different top view profiles.
 9. The method of claim 1, further comprising selecting a bone fusion device having tabs with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having tabs with different top view profiles.
 10. The method of claim 1, wherein the insertion of the bone fusion device is at an angle corresponding to a type of surgery selected from the group consisting of anterior, posterior, lateral, far lateral, extra lateral, extreme lateral and transforaminal.
 11. The method of claim 1, further comprising replacing one or more of the tabs of the bone fusion device with one or more replacement tabs.
 12. A method of implanting a bone fusion device into a desired location, the method comprising: providing a bone fusion device, the bone fusion device including a body having an interior cavity that houses a positioning element, a lock including a collar positioned around one end of the positioning element and a choke positioned around the collar, one or more tabs each having an inner surface and a support rib, and one or more extending blocks each having a rib slot, wherein the positioning element is coupled with the extending blocks; inserting the bone fusion device in the desired location; extending the one or more tabs from a retracted position within the interior cavity to an extended position at least partially outside the interior cavity by moving at least one of the plurality of extending blocks along the inner surface of the tabs such that the rib slots slide along the support ribs positioned at least partially within the rib slots; and locking the positioning element in place by rotating the choke until the choke causes the collar to constrict around the positioning element thereby impeding rotation of the positioning element.
 13. The method of claim 12, further comprising retracting the tabs of the bone fusion device into the retracted position before inserting the bone fusion device into the desired location.
 14. The method of claim 12, wherein moving the extending blocks comprises manipulating the positioning element of the bone fusion device.
 15. The method of claim 12, further comprising securing a gripping apparatus to the bone fusion device by inserting one or more fingers of the gripping apparatus into one or more channels on an exterior surface of the body of the bone fusion device.
 16. The method of claim 15, further comprising securing the fingers within the channels by inserting one or more fingertips of the fingers into one or more apertures of the channels.
 17. The method of claim 16, wherein the channels are positioned along the exterior surface on a plane perpendicular to a positioning aperture of the positioning element such that the fingers of the gripping apparatus are able to enter the channels by moving parallel to the plane.
 18. The method of claim 12, wherein an outward facing surface of the tabs comprises a plurality of teeth such that the outward facing surface is serrated.
 19. The method of claim 12, further comprising selecting a bone fusion device having a body with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having bodies with different top view profiles.
 20. The method of claim 12, further comprising selecting a bone fusion device having tabs with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having tabs with different top view profiles.
 21. The method of claim 12, wherein the insertion of the bone fusion device is at an angle corresponding to a type of surgery selected from the group consisting of anterior, posterior, lateral, far lateral, extra lateral, extreme lateral and transforaminal.
 22. The method of claim 12, further comprising replacing one or more of the tabs of the bone fusion device with one or more replacement tabs.
 23. A method of using a bone fusion device, the method comprising: securing a gripping apparatus to the bone fusion device by inserting one or more fingers of the gripping apparatus into one or more channels on an exterior surface of a body of the bone fusion device; providing the bone fusion device to a desired location, wherein the bone fusion device comprises the body having an interior cavity that houses a perimeter of each of one or more tabs, each tab of the tabs having an inner surface and a support rib, and one or more extending blocks each having a rib slot and an external surface configured to abut a portion of the inner surface of a respective tab, wherein an angle with respect to a common direction formed by the portion of the inner surface of the respective tab that abuts the external surface of the respective block is incongruent with an angle with respect to the common direction formed by an internally facing surface of the support rib that faces a bottom surface of the respective rib slot; and extending the one or more tabs in an extension direction from a retracted position to an extended position at least partially outside the interior cavity, wherein the rib slot of each of the extending blocks has a plurality of sidewalls substantially parallel to the extension direction, and further wherein each portion of the body remains fixed in place with respect to each other portion of the body during the extending of the one or more tabs.
 24. The method of claim 23, further comprising retracting the tabs of the bone fusion device into the retracted position before inserting the bone fusion device into the desired location.
 25. The method of claim 23, wherein moving the extending blocks comprises manipulating a positioning element of the bone fusion device coupled with the extending blocks and having a positioning aperture.
 26. The method of claim 23, further comprising securing the fingers within the channels by inserting one or more fingertips of the fingers into one or more apertures of the channels.
 27. The method of claim 26, wherein the channels are positioned along the exterior surface on a plane perpendicular to a positioning aperture of a positioning element of the bone fusion device coupled with the extending blocks such that the fingers of the gripping apparatus are able to enter the channels by moving parallel to the plane.
 28. The method of claim 23, wherein an outward facing surface of the tabs comprises a plurality of teeth such that the outward facing surface is serrated.
 29. The method of claim 23, further comprising selecting a bone fusion device having a body with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having bodies with different top view profiles.
 30. The method of claim 23, further comprising selecting a bone fusion device having tabs with a top view profile that substantially matches a cross sectional profile of bones in the desired location from a plurality of bone fusion devices having tabs with different top view profiles.
 31. The method of claim 23, wherein the insertion of the bone fusion device is at an angle corresponding to a type of surgery selected from the group consisting of anterior, posterior, lateral, far lateral, extra lateral, extreme lateral and transforaminal.
 32. The method of claim 23, further comprising replacing one or more of the tabs of the bone fusion device with one or more replacement tabs. 